Base Vitality PLLC
Organization Active NPI Clinic/Center · Kalispell, MT
NPI 1114727237 · NPPES record last updated Mar 17, 2026
Key facts
- NPI
- 1114727237
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinic/Center 261Q00000X
- Legal business name
- BASE VITALITY PLLC
- Practice address
- 103 Ponderosa LN
Kalispell, MT 59901-6833 - Phone
- (406) 220-5058
- NPI assigned
- Mar 17, 2025
- Organization subpart
- No
Authorized official
- Name
- Andrea L Emde
- Title
- Dr.
- Phone
- (406) 220-5058
Practitioners 1
-
Andrea L Emde, ND, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250428001555 | MT | Part B Supplier - Clinic/Group Practice | 1254857873 |
Receives reassigned benefits from 1 practitioner Practice locations: Kalispell, MT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | |||
| Clinic/Center | 261Q00000X | Yes |
Addresses
Primary practice location
103 Ponderosa LN
Kalispell, MT 59901-6833
Mailing address
103 Ponderosa LN
Kalispell, MT 59901-6833
Phone (406) 220-5058
Other providers in Kalispell, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.